PB2661: UPPER LIMB VENOUS THROMBOSIS ASSOCIATED WITH PICC AND ITS INFLUENCING FACTORS IN PATIENTS WITH HEMATOPOIETIC STEM CELL TRANSPLANTATION
Authors: Jie Tang, Aihua Sun, Jing Wen, Feng Ran, Fangfang Wu
Journal: HemaSphere (2023)

Topic: 34. Thrombosis and vascular biology - Biology & Translational Research Background: A central static catheter (peripherally inserted) was insertedcentral venous catheter (PICC) is widely used in patients with hematopoietic stem cell transplantation because the tip of the catheter reaches the superior vena cava, facilitating rapid dispersion and dilution of stimulant chemotherapy drugs after entering the bloodstream, thus reducing the stimulation of chemotherapy drugs on the vascular intima. PICC has been widely used in clinic as a safe, effective and painless intravenous channel for hematopoietic stem cell transplantation patients to be infused with super-large doses of chemotherapy drugs, blood products and nutritional support. However, as a kind of foreign body, the PICC catheter is placed into the patient’s blood vessel, which will cause the blockage of blood flow in the vessel and lead to blood stasis. Catheter-related thrombosis is one of the most common and serious complications in clinical application of PICC technology, which can lead to prolonged hospital stay and increased hospital costs for patients with hematologic tumors, and even life-threatening in severe cases. Aims: To compare the clinical features of upper limb venous thrombosis at different stages after peripheral venipentesis central venous catheter (PICC) catheterization in patients with hematopoietic stem cell transplantation, and to explore the influencing factors of thrombosis. Methods: A retrospective study was conducted on 120 patients with hematopoietic stem cell transplantation after PICC catheterization. The patients with PICC-associated upper limb venous thrombosis (PICC-CRT) 1 to 30 days after catheterization were in the recent thrombus group (4 cases), and the patients with PICC-CRT 31 to 210 days after catheterization were in the late thrombus group (2 cases). Results: 6 cases of PICC-CRT occurred, the total incidence was 5%. The incidence of asymptomatic thrombosis was higher in the recent thrombus group (P <0.05), and the incidence of symptomatic thrombosis was higher in the long-term thrombus group (P <0.05). There was statistical significance in clinical symptoms between the two groups (P <0.05). There was no significant difference in thrombus vein and thrombus degree between the two groups (P >0.05). There was no significant difference between the two groups in PICC catheterization history, puncture site, puncture vein, catheter/vein diameter ratio, catheterization length, puncture times, catheter delivery times and catheter tip location (P >0.05). There were statistically significant differences in the number of catheter lumen and complications between the two groups (P <0.05). There was no significant difference in total parenteral nutrition, blood transfusion, erythropoietin and chemotherapy drugs between 2 groups (P >0.05). After anticoagulation and thrombolytic therapy, the grading of venous thrombosis in the near-term thrombus group was better than that in the long-term thrombus group (P <0.05). Summary/Conclusion: The incidence of PICC-CRT in tumor chemotherapy patients changed with the time of catheterization. The characteristics of thrombus and related factors at different stages after catheterization are different, and corresponding intervention measures should be taken to reduce the incidence of PICC-CRT. Keywords: Thrombosis, Hematopoietic cell transplantation